CPOE: Literature Review and Possible Solutions

Weighted objectives Our facilities pay attention to the first four considerations of the CPOE system. Equally important to us is a system that is safe and easy to use for residents, so the weighting of each requirement is 30%. Although compliance with security and HIPPA is necessary, it is considered to be an industry standard of information systems and applications to some extent, and it is rated as 25%. Finally, it is possible to interact with other systems and applications, but we need to consider this approach. The value of this approach is 15%.

Abstract: In this article we provide a systematic literature review on outpatient safety CPOE assessment research, cost and efficiency, compliance guidelines, warnings, time, and satisfaction, use and availability. Thirty papers, including raw data (randomized clinical trials, nonrandomized clinical trials or observational research designs) met selection criteria. Only four studies evaluated the impact of CPOE on safety. There is little impact on the number of drug adverse events. Only one study showed a significant decrease in the number of medication errors. Drug prices dropped sharply in three studies, and five other studies failed to support this. Most studies on compliance guidelines have shown significant positive results. A relatively small number of assessment studies published to date have not been able to provide sufficient evidence that the CPOE system can improve outpatient safety and expense.

Four studies evaluated the effectiveness of CPOE implementation. One of them is Shamliyan et al. (2008) is a systematic review. The test results show that CPOE medication errors and harmful clinical events are reduced compared to children and adult handwritten commands regardless of patient or healthcare provider's characteristics. The survey ranged from 1995 to 2004, including 12 studies, one RCT, nine UBAs, and two unknown studies. The main conclusion is that the implementation of CPOE is associated with a significant reduction in dosage mistakes in adults and children. However, the results should be interpreted with caution. The effect may be overvalued by the use of random, uncontrolled intervention. Implementation of CPOE has nothing to do with substantial improvement in patient safety, and research does not allow for widespread universality.

Understanding workflows and redesigning inefficient processes is an important step to ensure the adoption of CPOE. CPOE is a destructive technology that fundamentally changes the process used to issue, confirm, approve, and execute orders. Researchers and practitioners have written extensively about the importance of redesigning workflows when implementing CPOE 6. Recipients took note of the recommendations in this document and made extensive investments in redesigning the process when planning the implementation of CPOE.